Background: Intensive Care Unit (ICU) delirium is a nonspecific, potentially preventable, and often reversible disorder of impaired cognition, which results from various causes in ICU patients. For appropriate management of delirium, early identification and risk factor assessment are key factors. Multidisciplinary collaboration and standardized care can enhance the recognition of delirium. Design: In this study, authors used the exploratory and descriptive study method. Method: The study was conducted in a group of 45 nurses of the cardiac intensive care unit. The department has 16 intensive care stations and is intended for patients after cardiac surgery who require intensive care in the postoperative period. Results: During the analysis the interviews, five Collective Subject Discourses were distinguished: signs and symptoms, physical restraint, use of sedatives, environment, and lack of education. Conclusion: Nurses have no knowledge of the factors contributing to the development of delirium, are unable to communicate with such patients and, most of all, do not know the consequences of the actions taken.

Providing intensive informal caregiving can cause caregivers’ overburden, possibly impacting successful ageing factors such as physical and mental health and social life. This article aimed to investigate how informal caregivers experience the impact of providing care for chronic respiratory patients on the process of caregiver ageing. A qualitative exploratory study was performed using semi-structured interviews. The sample comprised 15 informal caregivers who provided intensive care for patients with chronic respiratory failure for more than six months. They were recruited while accompanying the patients on their examination for chronic respiratory failure in Special Hospital for Pulmonary Disease in Zagreb between January 2020 and November 2020. Semi-structured interviews were used with informal caregivers, and interview transcripts were analysed by the inductive thematic analysis method. Similar codes were organised into categories, and categories were grouped into themes. Two themes were identified in the domain of physical health relating to informal caregiving activities and inadequate treatment of their difficulties, three themes were in the domain of mental health relating to satisfaction with the recipient of care and feelings, and two themes were in the domain of social life, relating to social isolation and social support. Informal caregivers of patients with chronic respiratory failure experience a negative impact on the factors that contribute to the successful ageing of informal caregivers. The results of our research suggest that caregivers need support in maintaining their own health and social inclusion.

Physiotherapy is an essential component of respiratory management and mobilisation/rehabilitation for patients in the Intensive Care Unit (ICU). However, the current practices across Europe related to organisational models, referral pathways, or clinical techniques are not well-defined. To examine physiotherapy provision and practice of respiratory management and mobilisation/rehabilitation for mechanically ventilated patients in European ICUs. An online survey was developed, piloted and distributed in 11 languages via national coordinators, professional societies, and social media. The ICU physiotherapy leads, or in their absence, medical/nursing leaders from each ICU (one reply per ICU), completed the survey, which included information regarding ICU structure, physiotherapy provision, and current practice. Data were analysed descriptively. In total, 845 responses from 33 countries were included, with the largest representation from Spain (12%), the United Kingdom (11%), and France (11%). Most respondents were physiotherapists (88%) working in university hospitals (69%) and caring primarily for adult ICU patients (87%). Less than half (41%) of physiotherapists were dedicated to ICU, but 91% of them had received some ICU-specific training. Physiotherapy is initiated upon a referral in 52% of ICUs. It usually includes routine respiratory assessment (80%) and both respiratory management and mobilisation/rehabilitation for mechanically ventilated patients (85%). The most common techniques included endotracheal suctioning (55%) and manually assisted cough (51%), with less frequent use of mechanical insufflation-exsufflation (20%) and saline instillation (18%). Mobilisation/rehabilitation was widely practised, with 76% of respondents reporting patients sitting at the edge of the bed, 69% standing, and 71% walking during their ICU stay. Physiotherapy is a well-integrated part in European ICUs with physiotherapists providing both respiratory management and mobilisation/rehabilitation techniques, although heterogeneity persists in organisation, referral pathways and the use of specific techniques. These results inform the development of future training and workforce planning, ultimately improving interprofessional ICU care across Europe, particularly in underrepresented areas.

Background: It is known that the consumption of single phytochemicals improves respiratory function in chronic obstructive pulmonary disease (COPD) patients. Since phytochemicals have a synergistic effect on health, a more comprehensive analysis is needed. The aim of this study was to estimate the intake of phytochemicals using the dietary phytochemical index (DPI) and assess their association with respiratory function, inspiratory muscle strength and function, and peripheral muscle strength. Methods: This study was conducted at the Special Hospital for Pulmonary Diseases in Zagreb (September 2023 to May 2024). The DPI was assessed using three 24 h recalls from 71 COPD patients (66.5 ± 8.4 years; 53.5% men). Anthropometric measurements, respiratory function, inspiratory muscle function and strength, and peripheral muscle strength were assessed during pulmonary rehabilitation following standard protocols. Results: Patients were divided into DPI tertiles with mean values of 7.3 ± 3.0, 16.0 ± 3.0, and 32.2 ± 8.8, respectively. After controlling for confounding factors, a significant association was found between DPI tertiles and FEV₁ (p-trend < 0.001), FVC (p-trend = 0.002), FEV₁/FVC (p-trend < 0.001), MIP (p-trend = 0.012), and MSUE (p-trend = 0.002). In addition, an inverse association was found between DPI tertiles and diaphragm thickness during inhalation (p-trend = 0.012) and exhalation (p-trend = 0.013). Conclusions: This study suggests that a higher intake of phytochemicals could be beneficial in dietary interventions for COPD therapy. Future prospective studies are needed to confirm these findings.

Background: Loneliness has become a growing public health problem. Adult people who live with chronic health problems often experience more severe consequences of this condition. The purpose of this research is to determine the level of loneliness and differences in dimensions of loneliness in adults living with cardiovascular diseases (CVDs). Methods: The study was conducted in the Magdalena Clinic for Cardiovascular Diseases. The selected sample consisted of a group of patients admitted for short-term hospital treatment. The data were collected using the 11-item De Jong Gierveld Loneliness Scale (DJGLS). Differences in outcomes with respect to gender, educational level and marital, work and living status, as well as medical diagnoses of the participants, were compared using the Kruskal–Wallis test or the Mann–Whitney U test. Spearman’s rho coefficient was used to analyze the correlation between the independent variables and the total score on different categories of loneliness. Results: A moderate level of loneliness (SD = 3.53; M = 3.0) was determined in almost half of the participants (N = 52; 49.1%). A statistically significant positive correlation was confirmed in the relationship between the emotional dimension of loneliness and the gender of the participants. The participants that had a lower education level showed a higher level of emotional loneliness, but also a higher overall level of loneliness. The age of the participants correlated negatively with the level of social loneliness (rho = −0.029). Conclusions: Loneliness is present among adults living with cardiovascular diseases in different dimensions and intensity. Although the connection between loneliness and health outcomes needs to be further investigated, the negative impact of this psychosocial problem on cardiovascular health cannot be ignored.